Rachel Nicole Carlson, PA-C, ATC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9112491 Issued in FL

Practice address

560 S Lakewood Dr Ste 101
Brandon, FL 33511-5015

Phone

(813) 978-9700

Fax

(813) 558-6186

NPI assigned

Oct 9, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Rachel Nicole Bianca Former name

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tallahassee Orthopedic Clinic III PLGroup PAC ID 4284532755, 538 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Josephs Hospital Hospital, Tampa, FL, CCN 100075

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: rachel.carlson.2@18802.direct.athenahealth.com
• Direct secure messaging: rachel.carlson.1@18802.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Tallahassee Orthopedic Clinic III PL

  dba Tallahassee Orthopedic Clinic

  • Medical Specialty Clinic/Center
  • Tallahassee, FL
  • NPI 1194778050
  Medicare reassignment Care Compare group NPD
• Musculoskeletal Institute Chartered

  dba Florida Orthopaedic Institute

  • Orthopaedic Surgery Physician
  • Temple Terrace, FL
  • NPI 1386639920
  Medicare reassignment
• Musculoskeletal Institute Chartered

  • Orthopaedic Surgery Physician
  • Clearwater, FL
  • NPI 1154954949
  NPD
• Tallahassee Orthopedic Clinic III, P.L.

  • Durable Medical Equipment & Medical Supplies
  • Panama City Beach, FL
  • NPI 1497617948
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St. Joseph's Hospital, Inc.

  dba St. Joseph's Women's Hospital

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1346519816
  Care Compare affiliation
• St. Joseph's Hospital, Inc.

  dba St. Joseph's Hospital

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1881632818
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1570579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1821630146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 S LAKEWOOD DR STE 101",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115015",
            "telephone_number": "813-978-9700",
            "fax_number": "813-558-6186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 S LAKEWOOD DR STE 101",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115015",
            "telephone_number": "813-978-9700",
            "fax_number": "813-558-6186"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "721 W Robertson St",
            "address_purpose": "LOCATION",
            "city": "Brandon",
            "state": "FL",
            "postal_code": "335114934",
            "country_code": "US",
            "telephone_number": "813-684-3707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "RACHEL",
        "middle_name": "NICOLE",
        "credential": "PA-C, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-09",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9112491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "MA473",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105589900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHEL",
            "last_name": "BIANCA",
            "middle_name": "NICOLE",
            "credential": "ATC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Waylon A Carlisle, PH.D.
• Ashley Marie Carlson, AP, DOM
• Matthew William Carman, M.D.
• Carmen Ramirez MD PA
• Esaleen Carmona
• Tatiana Carnero Veliz
• Carolyn M. Carey, MD, PA (Center for Pediatric Neurosurgery & Neuroscience)

• Physician Assistant in Brandon, FL
• Providers in Brandon, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.